How much rates vary
Facilitymedian $1,096 · 10th to 90th $631 to $4,467Professionalmedian $224 · 10th to 90th $98 to $1,349
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $512.86 Typical High $1,023.29 | Professional | None | $81.28 | $512.86 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $2,290.87 | Facility | None | $870.96 | $1,737.80 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $281.84 Typical High $1,513.56 | Professional | None | $97.72 | $281.84 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $1,380.38 | Professional | None | $114.82 | $177.83 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $1,445.44 Typical High $6,606.93 | Facility | None | $151.36 | $1,445.44 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $575.44 Typical High $1,148.15 | Professional | None | $104.71 | $575.44 | $1,148.15 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,148.15 | Facility | None | $645.65 | $1,047.13 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $1,479.11 Typical High $2,137.96 | Facility | None | $158.49 | $1,479.11 | $2,137.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $1,513.56 | Professional | None | $79.43 | $199.53 | $1,513.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,677.35 Median $6,606.93 Typical High $7,585.78 | Facility | None | $4,677.35 | $6,606.93 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $977.24 Typical High $1,148.15 | Professional | None | $131.83 | $977.24 | $1,148.15 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $120.23 Median $489.78 Typical High $1,513.56 | Professional | None | $120.23 | $489.78 | $1,513.56 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $257.04 Typical High $512.86 | Professional | 52 · Reduced service | $52.48 | $257.04 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $102.33 Typical High $204.17 | Professional | 53 · Discontinued | $21.38 | $102.33 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $380.19 Typical High $758.58 | Professional | 54 · Surgery only | $79.43 | $380.19 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $75.86 Typical High $151.36 | Professional | 55 · Aftercare only | $15.85 | $75.86 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $51.29 Typical High $102.33 | Professional | 56 · Pre-op care only | $10.47 | $51.29 | $102.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $194.98 Typical High $512.86 | Professional | 52 · Reduced service | $52.48 | $194.98 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $77.62 Typical High $204.17 | Professional | 53 · Discontinued | $21.38 | $77.62 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $295.12 Typical High $758.58 | Professional | 54 · Surgery only | $79.43 | $295.12 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $58.88 Typical High $151.36 | Professional | 55 · Aftercare only | $15.85 | $58.88 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $51.29 Typical High $102.33 | Professional | 56 · Pre-op care only | $10.47 | $51.29 | $102.33 |
Where Oregon sits
The same service costs 5.6 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $4,728MT $843
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.